Magnitude and Determinants of Perinatal Mortality in Southwest Ethiopia

Despite several efforts globally, the problem of perinatal mortality remained an unsolved agenda. As a result, it continued to be an essential part of the third sustainable development goals to end preventable child deaths by 2030. With a rate of 33 per 1000 births, Ethiopia has the highest level of perinatal mortality in the world. Thus, determining the magnitude and identifying the determinants are very crucial for evidence-based interventions. A community-based longitudinal study was conducted in Southwest Ethiopia among 3474 pregnant women to estimate the magnitude of perinatal mortality. Then, a case-control study among 120 cases and 360 controls was conducted to identify the determinants of perinatal mortality. Data were collected by using an interviewer-administered questionnaire and analyzed by using SPSS version 20. Multivariate logistic regression analysis was used to identify variables having a significant association with perinatal mortality at p<0.05. The perinatal mortality rate was 34.5 (95% CI: 28.9, 41.1) deaths per 1000 births. Attending ≥4 ANC visits (AOR=0.46; 95% CI: 0.23, 0.91), having good knowledge on key danger signs (AOR=0.27; 95% CI: 0.10, 0.75), and having a skilled attendant at birth (AOR=0.34; 95% CI: 0.19, 0.61) were significantly associated with a reduction of perinatal mortality. Being a primipara (AOR=3.38; 95% CI: 1.90, 6.00), twin births (AOR=5.29; 95% CI: 1.46, 19.21), previous history of perinatal mortality (AOR=3.33; 95% CI: 1.27, 8.72), and obstetric complication during labor (AOR=4.27; 95% CI: 2.40, 7.59) significantly increased perinatal mortality. In conclusion, the magnitude of perinatal mortality in the study area was high as compared to the national target for 2020. Care during pregnancy and childbirth and conditions of pregnancy and labor were identified as determinants of perinatal mortality. Hence, interventions need to focus on increasing knowledge of danger signs and utilization of skilled maternity care. Special emphasis needs to be given to mothers with a previous history of perinatal mortality, twin pregnancies, and having obstetric complications.

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The associations between risk behaviour and reported history of sexually transmitted diseases, among young women: a population-based study

International Journal of STD & AIDS ◽

10.1258/0956462971920659 ◽

1997 ◽

Vol 8 (8) ◽

pp. 501-505 ◽

Cited By ~ 36

Author(s):

Monica Jonsson ◽

Roger Karlsson ◽

Ewa Rylander ◽

Ake Gustavsson ◽

Goran Wadell

Keyword(s):

Alcohol Consumption ◽

Sexually Transmitted Diseases ◽

Univariate Analysis ◽

Previous History ◽

Multivariate Logistic Regression Analysis ◽

Risk Behaviour ◽

Population Based ◽

Sexual Partners ◽

Sexually Transmitted ◽

History Of

The aim of this study was to determine the associations between risk behaviour and women's reported sexually transmitted diseases (STDs). All the women aged 19, 21, 23 and 25, residing in a specified housing area, were invited to answer a questionnaire regarding their sexual behaviour, smoking and alcohol consumption and previous history of STD. Of the 611 women participating, one out of 4 women had a history of at least one STD. In an univariate analysis, self-reported STD was found to be related to age, having more than 4 lifetime sexual partners, having practised intercourse at first date, inconsistent use of condoms, alcohol consumption of more than 3 bottles of wine per month and smoking. These factors were, however, not independent of each other and when subjected to a multivariate logistic regression analysis 2 factors, i.e. the lifetime number of sexual partners (more than 4 partners vs one; OR 7.94, (3.41-18.50)) and coitus on first date (practised more than once vs never, OR 2.99 (1.55-5.78)) emerged as independently associated with a previous STD.

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RELATIONSHIP BETWEEN OBESITY, TWIN-PREGNANCY AND PREVIOUS HISTORY OF PREECLAMPSIA WITH PREECLAMPSIA

Indonesian Midwifery and Health Sciences Journal ◽

10.20473/imhsj.v5i3.2021.307-316 ◽

2021 ◽

Vol 5 (3) ◽

pp. 307

Author(s):

Riani Widia Parantika ◽

Gatut Hardianto ◽

Muhammad Miftahussurur ◽

Wahyul Anis

Keyword(s):

Risk Factors ◽

Previous History ◽

Significant Risk ◽

Multiple Pregnancies ◽

Chi Square ◽

Exact Test ◽

Pregnancy And Childbirth ◽

Increased Risk ◽

History Of ◽

Risk Of Preeclampsia

Background: Preeclampsia can threaten the health of the mother and fetus during pregnancy and childbirth, besides that it also increases the risk of long-term complications and has the potential to cause death. The incidence of preeclampsia at the RSUD Engku Haji Daud Tanjung Uban showed an increase in the last three years, namely the occurrence from 2017 as many as 23 cases to 56 cases in 2019. The condition of preeclampsia can worsen quickly and without warning, for that, it must be detected and managed appropriately. This study aimed to identify the association of obesity, multiple pregnancies, and previous history of preeclampsia with the incidence of preeclampsia in maternity women. Methods: This study uses a case-control study design. Performed on women giving birth in the period January – December 2019, consisting of 56 cases and 112 controls. Maternal women with preeclampsia were cases and women who were not diagnosed with preeclampsia were controls. The data was obtained from the respondents' medical records, then analyzed using the Chi-Square test or Fisher's Exact test with a value of = 0,05. Results: Obesity was associated with an increased risk of preeclampsia (OR= 4,746, 95% CI 2,381-9,460; P=0,000). Multiple pregnancies were associated with a significantly increased risk of preeclampsia (OR=15,857, 95% CI 1,899-132,384; P=0,002). Likewise, a previous history of preeclampsia was associated with a markedly increased risk of preeclampsia (OR=99,000, 95% CI 22,057-444,343; P=0,000). Conclusion: Based on these data, it was found that obesity, multiple pregnancies, and previous history of preeclampsia were significant risk factors for the occurrence of preeclampsia. It is important to identify risk factors for preeclampsia early, so that appropriate management can be carried out, to prevent complications.

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Predictors of healthcare worker burnout during the COVID-19 pandemic

10.1101/2020.08.26.20182378 ◽

2020 ◽

Author(s):

Amy V Ferry ◽

Ryan Wereski ◽

Fiona E Strachan ◽

Nicholas L Mills

Keyword(s):

Healthcare Worker ◽

Online Survey ◽

Previous History ◽

Multivariate Logistic Regression Analysis ◽

Primary Outcome Measure ◽

General Anxiety ◽

Patient Health ◽

History Of ◽

Anxiety Depression ◽

History Of Depression

Objective We aim to provide a snapshot of the levels of burnout, anxiety, depression and distress among healthcare workers during the COVID-19 pandemic. Design, setting, participants We distributed an online survey via social media in June 2020 that was open to any healthcare worker. The primary outcome measure was symptoms of burnout as measured using the Copenhagen Burnout Inventory (CBI). Secondary outcomes of depression, anxiety and distress as measured using the Patient Health Questionnaire-9, General Anxiety Scale-7, and Impact of Events Scale-Revised were recorded along with subjective measures of stress. Multivariate logistic regression analysis was performed to identify factors associated with burnout, depression, anxiety and distress. Results Of 539 persons responding to the survey, 90% were female, and 26% were aged 41-50 years, 53% were nurses. Participants with moderate-to-severe burnout were younger (49% [206/424] versus 33% [38/115] under 40 years, P=0.004), and more likely to have pre-existing comorbidities (21% versus 12%, P=0.031). They were twice as likely to have been redeployed from their usual role (22% versus 11%; adjusted odds ratio [OR] 2.2, 95% confidence interval [CI] 1.5-3.3, P=0.042), or to work in an area dedicated to COVID-19 patients (50% versus 32%, adjusted OR 1.6, 95% CI 1.4-1.8, P<0.001), and were almost 4-times more likely to have previous depression (24% versus 7%; adjusted OR 3.6, 95% CI 2.2-5.9, P=0.012). A supportive workplace team and male sex protected against burnout reducing the odds by 40% (adjusted OR 0.6, 95% CI 0.5-0.7, P<0.001) and 70% (adjusted OR 0.3, 95% CI 0.2-0.5, P=0.003), respectively. Conclusion Independent predictors of burnout were younger staff, redeployment to a new working area, working with patients with confirmed COVID-19 infection, and being female or having a previous history of depression. Evaluation of existing psychological support interventions is required with targeted approaches to ensure support is available to those most at risk.

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Role of ethnicity in thrombotic and hemorrhagic complications of myeloproliferative neoplasms.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18555 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18555-e18555

Author(s):

Andrew Peseski ◽

Antoine Saliba ◽

Hamid Sayar

Keyword(s):

Myeloproliferative Neoplasms ◽

Philadelphia Chromosome ◽

Previous History ◽

Multivariate Logistic Regression Analysis ◽

Vascular Complications ◽

Bleeding Complications ◽

Vascular Events ◽

Hemorrhagic Complications ◽

History Of ◽

Caucasian Patients

e18555 Background: Philadelphia-chromosome negative myeloproliferative neoplasms (MPN) are a group of hematologic malignancies with known complications of hemorrhage and thrombosis. Age and a previous history of thrombosis are well-documented risk factors for future vascular events. Variations in the rates of these complications among ethnicities and sexes have not been extensively explored. Methods: Our retrospective analysis included 301 adult patients with a diagnosis of MPN without a history of thrombosis or hemorrhagic event seen at the Indiana University Simon Cancer Center between 1992 and 2019. Relationships between ethno-racial backgrounds and vascular complications and disease outcomes were evaluated using multivariate logistic regression analysis and Cox regression models. Results: Two hundred seventy-one patients (90.0%) were Caucasian and 30 patients (10.0%) were non-Caucasian. Non-Caucasian patients were comprised of African America, Asian, and Middle Eastern ethnicities. Median age at diagnosis was 56 years, and 43.9% were male. No association was found between the incidence of thrombotic complications and ethnicity using the log-rank test ( p 0.68). The incidence of hemorrhagic events was significantly increased in non-Caucasian patients (OR = 4.33; 95% CI [1.15 – 16.36], p 0.03). Patients with higher hemoglobin concentration at diagnosis were at a significantly lower risk of bleeding complications (OR = 0.79; 95% CI [0.65 – 0.95], p 0.01). Non-Caucasian patients were at 2.98 times (95% CI [1.19 – 7.44], p 0.02) higher risk when vascular complications were pooled together. Our models also showed that male sex (OR = 0.14; 95% CI [.02 – .98], p 0.048) and a higher platelet count at the time of diagnosis (OR = 0.99; 95% CI [.993 –.999], p 0.03) had a marginally significant association with decreased rate of progression to acute myeloid leukemia. Conclusions: This study suggests that in patients without a history of thrombosis or bleeding, non-Caucasian ethnicity was associated with an increased adjusted risk of hemorrhagic complications in patients with MPN. This observation may inform future studies to further characterize those disparities in outcomes at the genetic or socioeconomic level.

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Magnitude and associated factors of caesarean section deliveries among women who gave birth in Southwest Ethiopia: institutional-based cross-sectional study

Archives of Public Health ◽

10.1186/s13690-021-00682-5 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Ayenew Mose ◽

Haimanot Abebe

Keyword(s):

Caesarean Section ◽

Urban Area ◽

Previous History ◽

Cross Sectional Study ◽

Multiple Pregnancies ◽

Sectional Study ◽

Cross Sectional ◽

Southwest Ethiopia ◽

Factors Associated ◽

History Of

Abstract Background Caesarean section is a life-saving comprehensive obstetric procedure of women and newborn performed during childbirth-related complications and should be universally accessible for all pregnant mothers globally. Appropriate use of caesarean section can reduce maternal and perinatal mortality. However, inappropriate use of caesarean section can negatively affect infant health, women health, and future pregnancies. The magnitude and factors associated with caesarean section delivery were not consistent and will vary between different hospitals of Ethiopia. Hence, this study aimed at assessing the magnitude and factors associated with caesarean section deliveries in Southwest Ethiopia. Methods and Materials An institutional-based cross-sectional study was conducted from January 1 to February 29, 2020. A systematic random sampling technique was used to select 551 study participants. A pretested, structured, and face-to-face interview was used to collect data. Data were entered into Epi-data version 4.2.0 and exported to SPSS version 23 for analysis. Bivariate and multivariate analyses were used to identify factors associated with caesarean section deliveries. P values < 0.05 result were considered as a statistically significant association. Results The magnitude of caesarean section deliveries was found to be 32.5 % (95 % CI; 28.6%-36.7 %). Mothers resided in an urban area [AOR = 2.58, (95% CI; 1.66–4.01)], multiple pregnancies [AOR = 3.15, (95% CI; 1.89–5.23), malpresentation [AOR = 3.05, (95% CI; 1.77–5.24)], and previous history of caesarean section [AOR = 3.55, (95% CI; 2.23–5.64) were factors associated with caesarean section deliveries. Conclusions Caesarean section deliveries were found high in the study area. Mothers resided in an urban area, multiple pregnancies, malpresentation, and previous history of caesarean section were factors associated with caesarean section deliveries. Therefore, counselling of mothers on the risk of giving birth through elective caesarean section without absolute and relative medical indications and giving enough time for the trial of vaginal birth after caesarean section are recommended.

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Extended Perinatal Mortality Audit in a Rural Hospital in India

American Journal of Perinatology ◽

10.1055/s-0041-1727220 ◽

2021 ◽

Author(s):

Núria Torre Monmany ◽

Joaquín Américo Astete ◽

Dasarath Ramaiah ◽

Jyothi Suchitra ◽

Xavier Krauel ◽

...

Keyword(s):

Mortality Rate ◽

Perinatal Mortality ◽

Perinatal Death ◽

Gestational Hypertension ◽

Action Plan ◽

Previous History ◽

Rural Hospital ◽

Neonatal Deaths ◽

The Status ◽

History Of

Objective The aim of the study is to describe the status of perinatal mortality (PM) in an Indian rural hospital. Study Design Retrospective analysis of data was compiled from PM meetings (April 2017 to December 2018) following “Making Every Baby Count: audit and review of stillbirths and neonatal deaths (ENAP or Every Newborn Action Plan).” Results The study includes 8,801 livebirths, 105 stillbirths (SBs); 74 antepartum stillbirths [ASBs], 22 intrapartum stillbirths [ISBs], and nine unknown timing stillbirths [USBs]), 39 neonatal deaths or NDs (perinatal death or PDs 144). The higher risks for ASBs were maternal age >34 years, previous history of death, and/or SBs. Almost half of the PDs could be related with antepartum complications. More than half of the ASB were related with preeclampsia/eclampsia and abruptio placentae; one-third of the ISB were related with preeclampsia/eclampsia and gestational hypertension, fetal growth restriction, and placental dysfunction. The main maternal conditions differed between PDs (p = 0.005). The main causes of the ND were infections, congenital malformations, complications of prematurity, intrapartum complications, and unknown. The stillbirth rate was 11.8/1,000 births, neonatal mortality rate 4.4/1,000 livebirths, and perinatal mortality rate 15.8/1,000 births. Conclusion This is the first study of its kind in Andhra Pradesh being the first step for the analysis and prevention of PM. Key Points

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Risk Factors for Pulmonary Hypertension In Patients with Thalassemia Intermedia

Blood ◽

10.1182/blood.v116.21.2069.2069 ◽

2010 ◽

Vol 116 (21) ◽

pp. 2069-2069

Author(s):

Mehran Karimi ◽

Khaled M Musallam ◽

Maria Domenica Cappellini ◽

Amal El-Beshlawy ◽

Khawla Belhoul ◽

...

Keyword(s):

Pulmonary Hypertension ◽

United Arab Emirates ◽

Conflicts Of Interest ◽

Previous History ◽

Multivariate Logistic Regression Analysis ◽

Iron Chelation ◽

Thalassemia Intermedia ◽

Group I ◽

History Of ◽

Group Ii

Abstract Abstract 2069 Introduction: Mechanisms leading to pulmonary hypertension (PHT) in patients with thalassemia intermedia (TI) are still controversial. Moreover, clinical and laboratory characteristics of patients who eventually develop PHT have not been identified. Our aim was to identify factors that characterize TI patients who develop PHT. Methods: Data was retrospectively retrieved from the Thalassemia Intermedia Registry, a database of 584 TI patients currently registered at six comprehensive care centers in Lebanon, Italy, Iran, Egypt, United Arab Emirates, and Oman. Institutional review boards at each center approved the study protocol. Two Groups of patients were identified: Group I, TI patients with documented PHT (n=64; mean age 37.3 ± 10.6; 44% males); and Group II, age- and sex-matched TI patients without PHT (n=64; mean age 37.9 ± 11.4; 44% males). Collected data included demographics, laboratory parameters, disease-complications, and received treatments that may influence PHT development and reflected the period prior to PHT occurrence. Results: There were no statistically significant differences in mean platelet counts, total or fetal hemoglobin levels between the two Groups. However, mean serum ferritin level was higher in Group I compared to Group II (1233.2 ± 499.2 vs. 654.7 ± 234.5 ng/ml; P=0.01). Moreover, mean nucleated red blood cell (NRBC) count was higher in Group I compared to Group II (354.2 ± 199.2 vs. 214.7 ± 94.5 ×10⋀6/l; P=0.03). A higher proportion of patients were splenectomized (84.4% vs. 46.9%; P<0.001) or had a previous history of thromboembolic events (40.6% vs. 7.8%; P<0.001) in Group I compared to Group II. Conversely, a higher proportion of patients received transfusion (78.1% vs. 56.2%; P<0.001), iron chelation (62.5% vs. 37.5%; P<0.001), or hydroxycarbamide (34.4% vs. 17.2%; P<0.001) therapy in Group II compared to Group I. There were no statistically significant differences in the proportion of patients with heart failure, prothrombotic mutations, or receiving antiplatelet or anticoagulant therapy between the two Groups. Multivariate logistic regression analysis revealed that patients in Group I are more likely to be splenectomized (OR:4.9, 95%CI:1.9-8.5); transfusion-naive (OR:3.5, 95%CI:2.1-6.25); on no hydroxycarbamide (OR:2.6, 95%CI:1.1-5.25) or iron chelation therapy (OR:2.3, 95%CI:1.2-4.25); and have NRBC count >300 ×10⋀6/l (OR:2.59, 95%CI:1.69-6.05) or a previous history of thromboembolism (OR:3.69, 95%CI:2.38-7.05). Conclusion: Splenectomy, previous history of thromboembolism, and a high NRBC count characterize TI patients who develop PHT. Transfusion, iron chelation, and hydroxycarbamide therapy deserve evaluation for a protective role against PHT in TI. Disclosures: No relevant conflicts of interest to declare.

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How well urban families are prepared for child birth and its complications

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20202059 ◽

2020 ◽

Vol 7 (6) ◽

pp. 2124

Author(s):

Pujitha Vallivedu Chennakesavulu ◽

Cuddapah Gaurav Venkat ◽

Suddapalli Siva Keerthana ◽

Harika Govada ◽

Reddivari Preethi

Keyword(s):

Reproductive Age ◽

Research Centre ◽

Birth Preparedness ◽

Age Group ◽

Complication Readiness ◽

New Born ◽

Danger Signs ◽

Pregnancy And Childbirth ◽

Knowledge Of Danger Signs ◽

Reproductive Age Group

Background: Globally every day, approximately 830 women die from preventable causes related to pregnancy and childbirth. 99% of all maternal deaths occur in developing countries. Care before during and after childbirth can save the lives of women and new born babies which is also known as birth preparedness and complication readiness (BPACR). The objective of this study aims to assess practice of birth preparedness and complication readiness among families of women in the field practicing area of Kamineni Academy of Medical Sciences and Research Centre, Hyderabad.Methods: Field based descriptive study was done during August 2019 to February 2020 for a period of 6 months in urban field practising area. Sample size was 450 families, which includes, antenatal mothers 450 and their husbands 450, and 220 reproductive age group women. Results: Awareness of key danger signs during pregnancy (73.8%), labour/childbirth (56.7%) and postpartum (44%) were more among antenatal women whereas knowledge of danger signs of new born was highest among husbands of currently pregnant women. Planning of giving birth with a skilled provider was also high among antenatal women (98%) and in their husbands (97.5%), but saving for the same was very low in reproductive age group study population (20.4%).Conclusions: All these findings conclude Indian husbands of urban were more concerned about problems and safety of their offspring that is new born, than antenatal mother. Awareness of danger signs in the new born was lowest.

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Association Between Ultrasound Parameters and History of Ischemic or Hemorrhagic Stroke in Patients With Moyamoya Disease

Frontiers in Neurology ◽

10.3389/fneur.2021.570843 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shuai Zheng ◽

Peicong Ge ◽

Yi Li ◽

Jingzhe Wang ◽

Zhiyong Shi ◽

...

Keyword(s):

Moyamoya Disease ◽

Hemorrhagic Stroke ◽

Previous History ◽

Multivariate Logistic Regression Analysis ◽

Peak Systolic Velocity ◽

Training Dataset ◽

Validation Dataset ◽

Calibration Plot ◽

History Of ◽

Ultrasound Parameters

Objective: To explore the association between ultrasound parameters and previous ischemic or hemorrhagic stroke in patients with moyamoya disease (MMD), and develop an ultrasound-based nomogram to identify stroke in patients with MMD.Methods: We prospectively enrolled 52 consecutive patients (92 hemispheres) with MMD at the Beijing Tiantan Hospital. Thirty-six patients (65 hemispheres) were assigned to the training dataset from September 2019 to February 2020, and 16 patients (27 hemispheres) were assigned to the validation dataset from March 2020 to July 2020. Multivariate logistic regression analysis was applied to identify ultrasound parameters associated with previous history of ipsilateral stroke in patients with MMD, and a nomogram was subsequently constructed to identify stroke in patients with MMD. The performance of the nomogram was evaluated with respect to discrimination, calibration, and clinical usefulness.Results: Multivariate analysis indicated that the flow volume (FV) of the extracranial internal carotid artery (EICA) and the peak systolic velocity (PSV) of the posterior cerebral artery (PCA) were independently associated with ipsilateral stroke in patients with MMD, a nomogram incorporating these two parameters was constructed to identify stroke patients. The area under the receiver operating characteristic (AUROC) curves was 0.776 (95% CI, 0.656–0.870) in the training dataset and 0.753 (95% CI, 0.550–0.897) in the validation dataset suggested that the model had good discrimination ability. The calibration plot showed good agreement in both the two datasets. The decision curve analysis (DCA) revealed that the nomogram was clinically useful.Conclusions: Ultrasound parameters of EICA and PCA are independently associated with history of previous ipsilateral ischemic or hemorrhagic stroke in patients with MMD. The present ultrasound-based nomogram might provide information to identify MMD patients with high risk of stroke. Future long-term follow-up studies are needed to prove the predictive value in other independent cohorts.Clinical Trial Registration:http://www.chictr.org.cn/index.aspx. Unique Identifier: ChiCTR1900026075.

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Determinants of perinatal mortality in Ethiopia from 2012 up to 2020: systematic review and meta-analysis

10.21203/rs.3.rs-143282/v1 ◽

2021 ◽

Author(s):

Daniel Getahun ◽

Samuel Habtegiorgis ◽

Wodaje Assfaw ◽

Moges Assemie

Keyword(s):

Perinatal Mortality ◽

Birth Interval ◽

Maternal Education ◽

Perinatal Death ◽

Random Effect Model ◽

Previous History ◽

Cochrane Library ◽

Child Birth ◽

Time Period ◽

History Of

Abstract Background: The perinatal mortality is defined as neonatal deaths of less than seven days of age and fetal deaths after 28 weeks of gestation for developing countries. Perinatal mortality is a worldwide health problem even if variation exists among countries. Despite the presence different studies done on the determinants of perinatal mortality in Ethiopia, there is no comprehensive and currently updated study in this time period in Ethiopia. The objective of this study was to determine the determinants of perinatal mortality in Ethiopia from 2012 up to 2020 time period.Method: The articles were identified through electronic search of reputable databases: Google scholar, PubMed, Cochrane library, MIDLINE, EMBASE and Ovid Maternity and Infant Care Databases. Nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Analysis was done by using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used and a random effect model was also used to estimate the pooled prevalence of perinatal mortality rate. Results: The determinant factors for perinatal mortality were gestational age less than 37weeks , birth weight greater than or equal 2500 gram , had not history of previous abortion, had not history of perinatal death, illiterate maternal education, not using partograph , not vaccinated women about TT vaccine, had not history of obstetric complication ,level of hemoglobin greater than or equal to 11mg/dl ,women who had no prenatal visit ,child birth interval less than two years and non-vertex fetal presentation were significantly associated with perinatal mortality.Conclusion: Government should give especial emphasis for women’s with previous history of abortion, perinatal death and child birth interval less than two years.as well as strengthen all the above associated variables.

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